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Updated: May 25, 2026

Treatment of Liver Metastases Using an Internal Target Volume Method for Stereotactic Body Radiotherapy
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Radiosurgical dose selection for brain metastasis.

James B Yu1, Michael Schulder, Jonathan Knisely

  • 1Yale University School of Medicine, Department of Therapeutic Radiology, Smilow Cancer Hospital, New Haven, CT, USA.

Progress in Neurological Surgery
|January 13, 2012
PubMed
Summary
This summary is machine-generated.

Selecting the right radiosurgery dose for brain metastases is crucial for lifelong tumor control without causing radiation necrosis. Dose selection balances tumor control with minimizing damage to surrounding healthy brain tissue.

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Area of Science:

  • Neurosurgery
  • Radiation Oncology
  • Medical Physics

Background:

  • Dose selection for brain metastasis radiosurgery relies on historical data from diverse conditions.
  • Accurate calibration, imaging, and planning are essential for radiosurgical success.
  • The goal is lifelong, uncomplicated tumor control, avoiding both under- and over-dosing.

Purpose of the Study:

  • To review current practices and considerations for dose selection in brain metastasis radiosurgery.
  • To highlight the importance of tumor volume and surrounding tissue dose in determining optimal radiation doses.
  • To discuss findings from dose-escalation trials and identify gaps in current knowledge.

Main Methods:

  • Review of clinical data and outcomes from historical radiosurgery treatments.
  • Analysis of dose-escalation trial results, including those from the Radiation Therapy Oncology Group.
  • Consideration of factors influencing dose choice, such as prior radiation therapy and chemotherapy.

Main Results:

  • Single-fraction doses of 15-24 Gy are relatively safe for patients with prior radiation therapy.
  • Data for primary radiosurgery without prior whole brain radiation therapy is lacking.
  • Conformality and steep dose gradients reduce complications.

Conclusions:

  • Dose selection requires balancing tumor control with the risk of radiation necrosis.
  • Tumor size, prior treatments, and treatment planning significantly impact dose choice.
  • Further research, including ongoing trials, is needed to refine brain metastasis radiosurgery dosing.